Viral, Dengue or Typhoid? Spot the difference in common monsoon fevers

The commonly encountered illnesses are viral fever, dengue, and typhoid—all with overlapping symptoms: high fever, body ache, fatigue, and weakness can make it hard to differentiate. (Image: Pexels)

The monsoon provides a much-needed break from the oppressive summer, but it also ushers in many seasonal illnesses. The commonly encountered illnesses are viral fever, dengue, and typhoid—all with overlapping symptoms: high fever, body ache, fatigue, and weakness can make it hard to differentiate these conditions without formal medical evaluation. Recognizing the conditions is important for timely evaluation, diagnosis, and specific treatment.

Dr. Ajay Kumar Gupta, Senior Director & Head - Internal Medicine, Max Super Speciality Hospital, Vaishali, suggests some of the salient distinguishing characteristics of the illnesses associated with the monsoon:

1. Onset and character of fever.

- Viral fever: Accumulate onset of fever usually sudden, often also feeling tired, headache, and mild body ache. Typically passive for 3–5 days and usually, responsive to symptomatic treatment.

- Dengue: High-grade fever often above 102F/39C. Sudden onset "breakbone fever" due to severe headache, bodyache, and joint pain. Fever may come down and then return in a "saddle-back" pattern.

- Typhoid: Bandering rise of temperature most often by gradual increase every couple to a few days, often by the end of the first week fever reaches its peak; fever is persistent, and is associated with chills/sweating.

2. Related Symptoms

- Viral Fever: Symptoms of viral fever can include sore throat, runny nose, cough, mild diarrhoea and general malaise.

- Dengue: Signs warning of worsening dengue fever can include severe headache (especially behind eyes), skin rash, gum or nose bleeding, and low platelet count (>15000).

- Typhoid: Symptoms of typhoid include abdominal pain and either constipation or diarrhoea, or poor appetite. Some patients will have a coated tongue, and the abdominal pain may be accompanied by a rose coloured rash.

3. Mode of Transmission

- Viral Fever: Viral fever can be passed either in air (coughing or sneezing) or on contaminated surfaces. It is especially contagious in closed environments.

- Dengue: Dengue is spread by the bite of Aedes mosquito that breed in stagnant water and bite during the day.

- Typhoid: Typhoid is caused by the bacteria Salmonella typhi, and spreads primarily through contaminated food and water. Hygiene and sanitation are particularly important in preventing the spread of typhoid and bacterial disease.

4. Observational Indicators

- Viral Fever: Viral fever is commonly diagnosed clinically, and laboratory blood tests are not generally needed unless symptoms persist.

- Dengue: Dengue requires blood tests for NS1 antigen, IgM/IgG antibodies, and monitoring of platelet counts.

- Typhoid: If suspected, typhoid is diagnosed using blood culture or Widal test. Blood reports may reveal low white blood cell counts, or changes to normal liver function tests.

5. Treatment Approach

- Viral Fever: Mostly self-limiting caused and requires rest, fluid intake and over-the-counter fever reducers.

- Dengue: No specific antiviral treatment; management is supportive with hydration and monitoring for life-threatening complications such as bleeding or shock.

- Typhoid: Requires antibiotics, prescribed by the doctor. Millar says the recovery is gradual, and may relapse, if not having completed the full course of antibiotics.

Although the symptoms of monsoon disease may appear similar at the outset, consistent differences in the onset, course, and accompanying signs may provide key clues to the pathogenesis. The early consultation of a medical professional with the required diagnostic tests are essential in obtaining values and avoiding complications.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis